By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Is sunscreen safe? Is it really the best sun protection? We take sunscreen safety for granted because public health officials have done a stellar job educating the public about the dangers of excess sun exposure. But few people actually question what’s in the sunscreens they’re slathering or spraying all over their bodies. Most sunscreens contain chemicals that are toxic for us, as well as the environment. And at least some lawmakers are starting to address the consequences of unchecked sunscreen use. Hawaii – known for having strict environmental protection laws – recently stepped up and took a stand against some of the toxic chemicals in sunscreens.
In April 2018, Hawaii passed a first-of-its kind bill to prohibit sales of certain sunscreens, ones that contain oxybenzone and octinoxate. Although there are numerous chemicals of concern in most sunscreens, oxybenzone and octinooxate are known to damage coral reefs and marine life. They also happen to be in over 3,500 popular sunscreen products.
I’m all for this bill, despite its threat of inconvenience…It makes a vital statement about man’s chemical impact on this planet (now…if only lawmakers would wake up and smell the coffee about toxic pesticides!). Hopefully, this bill will actually become a law and catalyze more mainstream conversations about the chemicals in our sunscreens and personal care products. I’ll dive further into sunscreen safety below; but before I do, let’s talk about why we need sun protection in the first place.
Sun Protection In the Name of Skin Cancer
We all know two main reasons that getting too much sun is bad for us: premature aging, and – more importantly – increased risk of skin cancer.
Chronic, excessive exposure to ultraviolet (UV) rays from the sun or tanning booths can cause wrinkles by breaking down collagen and elastin, connective tissues that keep our skin firm and young. Getting too much sun also significantly increases risk of common skin cancers like non-melanoma basal and squamous cell carcinomas, especially if you’ve also suffered bad sunburns during childhood and adolescence. And if you are a person with many moles and fair features such as blue eyes and red hair, you do have an increased risk of developing melanoma, a much more serious type of skin cancer (interestingly, melanoma can develop on areas of the skin not generally exposed to the sun).
All considered, it seems like a no-brainer to slather on copious amounts of sunscreen, right? Nope. After learning what I have about sunscreens, I don’t think they are the best sun exposure solution.
Why Sunscreens Are Not the Best Sun Protection
According to the Environmental Working Group (EWG), a leading environmental health research and advocacy watchdog organization, skin cancer incidence continues to rise even among frequent sunscreen users:
“There is little scientific evidence to suggest that sunscreen alone reduces cancer risk, particularly for melanoma, the most deadly type of skin cancer. Despite a growing awareness of the dangers of exposure to the sun’s ultraviolet radiation, and a multi-billion dollar sunscreen industry, melanoma rates have tripled over the past three decades.”
Here’s one reason why: feeling protected, people are apt to spend more time in the sun than people who don’t use sunscreen. Problem with this is, most sunscreens produced within the past several decades don’t actually offer much sun protection because they were designed to block only UVB (shorter wavelength) and not UVA (longer wavelength) rays. Both types of UV can cause skin cancer and accelerated skin aging. And UVBs only account for 3 to 5 percent of the total UV radiation that makes it through our atmosphere, while UVA rays constitute the remaining 95 to 97 percent and they penetrate deeper into the skin. Hence, many sunscreens offer a false sense of protection.
Ideally, you want a “broad spectrum” sunscreen, one that has passed testing approved by the U.S. Food and Drug Administration (FDA) in 2012, and which protects against both types of UVs.
There’s another catch here. Sunscreens often contain toxic chemicals like oxybenzone and octinoxate, especially the products that you spray on. Some of the risks posed by these chemicals include allergies, endocrine dysfunction, neurological, reproductive and immune system toxicity, and even cancer. Using chemical-laden sunscreen for a week during a tropical vacation probably won’t hurt you, but regular use for years and years can carry a risk.
Sunscreens may not only be toxic for the people using them, but they also contribute to environmental pollution. When you shower and wash off those chemicals, they go down the drain, and into an aquatic environment, adding to an already serious man-made burden on the environment. As the recent Hawaii bill elucidates, chemicals like oxybenzone damage coral reefs, and impact all the sea creatures that rely on those reefs for food and shelter. Humans also depend on coral reefs for food, income and enjoyment. We’re all interconnected, and environmental damage ultimately impacts us on some level.
How to Find “Safe” Sunscreens
To be really frank here, there really aren’t any 100 percent safe sunscreens. Even the “safest” mineral sunscreens contain nanoparticles, which may impact human health (as well as the environment). If you’re going to be out in the sun a lot, or during peak hours for more than 20 minutes, try finding the least toxic, most natural sunscreen you can that also offers “full spectrum” protection. Also look for a product with an SPF (which means “skin protection factor”) of 30 to 50 (an SPF higher than 50 is not necessarily better) .
Go Online to EWG’s 2018 Guide to Sunscreens
Since 2004, EWG has offered an online (and free) Skin Deep database, through which you can learn which personal care products like sunscreens are on the safer side, and which are more toxic. Recently, the EWG started providing a Guide to Sunscreens through which you can browse sunscreen-specific sub-databases for the best beach and sports sunscreens, best and worst scoring kids’ sunscreens, and more; here’s the 2018 version.
In general, EWG recommends using mineral sunscreens that have compounds such as zinc oxide or titanium dioxide over non-mineral types, containing substances like avobenzone, octinoxate and oxybenzone. Some sunscreens are both mineral and non-mineral. It’s best to avoid the non-mineral chemicals, especially oxybenzone. Mineral sunscreens pose less risk of toxicity while providing better UVA protection. However, they still contain nanoparticles that can be toxic if they enter the bloodstream, for example after absorption through the skin.
EWG’s safest pick is zinc oxide sunscreen (what the lifeguards used to put on their noses and lips) – something used to treat diaper rash: “It is stable in sunlight and can provide greater protection from UVA rays than titanium oxide or any other sunscreen chemical approved in the U.S.” Citing the need for more research and FDA guidelines to help reduce any risk posed by mineral sunscreens, and to maximize their sun protection effectiveness, EWG also notes, “even with the existing uncertainties, we believe that zinc oxide and titanium dioxide lotions are among the best choices on the American market.”
Read Sunscreens- Biohazards: Treat as Hazardous Waste
If you like to spend a lot of time out in the sun, as I do, I strongly recommend educating yourself, as I did, by reading Sunscreens- Biohazards: Treat as Hazardous Waste, by Elizabeth Plourde, Ph.D. She has gathered a wealth of eye-opening information that will make you think twice about what you smear on your skin before you go out and bake in the sun. You may very well be causing damage and premature aging, just the very things you think you are trying to protect yourself against.
Why You Need Some Unprotected Sun Exposure
As I mention in Is Sunshine Good for You?, absorbing sunlight is the most natural way for your body to get the Vitamin D it needs to stay healthy. The key is getting the right amount of sun. Ideally, to get enough Vitamin D, you should expose your skin to the sun’s mid-day rays (between peak hours of 10 a.m. and 3 p.m.) for 10 to 20 minutes each day. It’s important that you don’t wear sunscreen during this time because sunscreen inhibits vitamin D3 synthesis by blocking UVB rays. But if you are out in the sun regularly and for longer periods of time, especially during peak hours, you may put yourself at risk of UV damage if you don’t use protective clothing or sunscreen. Sunlight is a double-edged sword, if you will.
Sun Protection Methods that Are Safer than Sunscreen
Until an absolutely safe sunscreen is found, my advice is to wear sun protective shirts and other protective clothing (I sure do!) such as a wide-brimmed hat, and stay in the shade as much as possible. The lighter and thinner your clothing, the greater the chances that UV rays will penetrate through to your skin. So, if your regular heavy, dark clothes are too uncomfortable, I suggest wearing clothing that’s made especially to protect against sun exposure and comes with a decent SPF rating. That’s the best protection. If you’d rather wear less clothing, go with a zinc oxide sunscreen.
Michael F. Holick, M.D., a leading medical expert on Vitamin D, advises people to shield their faces when out in the sun because faces get the most sun exposure and are most prone to damage. Better to expose your arms, legs, back or stomach area when trying to absorb some rays, he says.
Face masks, which screen out 95 percent of UV rays, are often available through fishing and skiing retailers. That’s another good form of protection.
I also recommend CoQ10 (100-150 mg daily). This super supplement can provide protection for the first 15-20 minutes in the sun, when the body’s own supply is used up as an antioxidant in the skin.
My Sun Story
My mom – a fair-skinned, Irish gal, had skin cancer (basal and squamous cell carcinoma) when she was in her sixties and had to undergo extensive surgery as a result. So, with that kind of family history and my own fair skin, I’ve long been aware of my vulnerability. So, being the “sun-phobe” I am, an avid fisherman and skier for many years, I have learned to cover up almost completely whenever I’m in the sun for more than a few minutes.
I follow the advice that I’ve been giving others to the letter, and even beyond. I used to be the “king of sunblock” until I found out that there is no safe sunblock. I’ve always worn hats, long pants, long sleeves, and big sunglasses. On beach vacations I imagine I can be downright embarrassing to be seen with. I have barely a shred of skin uncovered. Though some might think me “overboard,” I’m just trying to protect myself as best as I can.
You can imagine the shock I experienced in fall of 2011 when I learned that some innocent-looking little spots on my face were squamous cell lesions, despite all my prevention.
Let my story serve as a warning. Whether you have fair skin or not, make it your business to treat the sun with the greatest respect.
My Bottom Line Sun Recommendations:
- Get enough daily sun (10 – 20 minutes), unprotected; after that wear protective clothing, stay in the shade, or find the least toxic, most natural sunscreen you can that also is broad spectrum (has passed testing approved by the FDA in 2012). I agree with EWG: zinc oxide sunscreen is okay.
- Visit a dermatologist regularly, and have him or her visually scan your whole body. If you have a history of skin cancer, discuss it with your dermatologist.
- Spend time outdoors, e.g. walking or doing yard work, when the sun is weaker: in early morning or evening hours.
- Worship the shade instead of the sun when relaxing outdoors.
References and Resources:
- Downs G. Sunscreen Pollution. Marinesafe.org, March 18, 2016.
- Environmental Working Group (EWG). The Trouble with Ingredients in Sunscreens. EWG.org, Accessed May 22, 2018.
- Environmental Working Group (EWG)’s Skin Deep. Sunscreen and Skin Cancer. Ewg.org, June 23, 2011.
- EWG. EWG’s Sunscreen Guide: A Decade of Progress, But Safety and Marketing Concerns Remain. Accessed July 9, 2016.
- EWG. Nanoparticles in Sunscreens. EWG.org, accessed July 11, 2016 and May 23, 2018.
- EWG. What’s Wrong with High SPF? EWG.org, accessed May 23, 2018.
- Heaney RP. Vitamin D: criteria for safety and efficacy. Nutr Rev. 2008 Oct;66(10 Suppl 2):S178-81.
- Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancer and cardiovascular disease. Am J Clin Nutr, Dec. 2004;80(6):1678S-1688S.
- Matsuoka LY, Ide L, Wortsman J, MacLaughlin J, Holick MF. Sunscreens suppress cutaneous vitamin D3 synthesis. J Clin Endocrinol Metab. 1987;64:1165–8.
- National Public Radio (NPR). Hawaii Approves Bill Banning Sunscreen Believed To Kill Coral Reefs. Npr.org, May 2, 2018.
- Plourde, Elizabeth. Sunscreens – Biohazard: Treat as Hazardous Waste (New Voice Publications 2011).
- Reef Resilience Network. Bleaching Impacts. Reefresiliance.org, accessed May 23, 2018.
- Venosa A. Dress to Protect: 5 Things that Affect How Well Your Clothes Block UV Rays. Blog.skincancer.org, Accessed May 23, 2018.
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